Do you Know What to Do? May is Stroke Awareness Month
By Shari Botts, BSN, RN, CPHQ, C-ONQS, CIC
You are out to dinner with a friend, and she complains of the sudden onset of a headache and her speech seems a bit slurred. What do you think is going on? Do you know what to do?
May is Stroke Awareness Month. Stroke is currently the 5th cause of death in the United States. According to the National Institutes of Health (NIH), about 795,000 people have a stroke each year, and about 142,000 will die. Stroke is also a leading cause of long-term disability. This month we’ll focus on the risk factors, symptoms, and prevention of stroke.
Blood vessels supply the required oxygen to our brain. If a clot develops and creates a blockage in a blood vessel (Ischemic Stroke) or a blood vessel tears/ruptures (Hemorrhagic Stroke), this oxygen supply is cut off and brain cells will die, leading to a Stroke; also known as a Brain Attack or Cerebrovascular Accident (CVA). Transient Ischemic Attack (TIA) can present as a mild stroke; symptoms typically resolve within 24 hours.
BE FAST
Of course, we want to act quickly; this is also an acronym to help us know the signs and symptoms of a Stroke. You may have heard the phrase “time is muscle” for the urgency needed for treatment of heart attacks; we say “time is brain” when it comes to stroke to emphasize the urgency for treatment of Stroke.
B: Balance. Is there trouble with balance?
E: Eyes. Is there a disturbance in vision (double vision, blurred vision, or sudden loss of vision)?
F: Face. Does one side of the face droop?
A: Arms. Is one arm weaker than the other?
S: Speech. Is there slurring of speech?
T: Time. Call 911 immediately if any of these signs and symptoms are present. Make note of the time when symptoms began.
Other symptoms of Stroke include: headache, confusion, and numbness in arms or legs, especially if only on one side of the body.
RISK FACTORS
Uncontrollable risk factors include:
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Age. Risk increases with age and is more common among those 65 and older; however, strokes can happen at any age.
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Gender & Race. Women and Black persons have higher risk for stroke and stroke-related death.
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Family history. Risk increases if a parent, grandparent, or sibling has had a stroke (especially if before age 65).
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Personal history of stroke, transient ischemic attack (TIA), or heart attack.
PREVENTION
The good news is that up to 80% of strokes are preventable. While we can’t control the risk factors above, there are some risks that can be minimized:
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High Blood Pressure. Know your blood pressure and take any prescribed medications to manage high blood pressure.
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Smoking. Do NOT smoke or vape
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Diet. Eat the rainbow of healthy fruits and vegetables, and decrease intake of saturated fats, trans fats, sodium, and sugar.
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Physical inactivity. Do regular physical activity.
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Obesity. Maintain a healthy weight.
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High cholesterol. Know your cholesterol level and take any prescribed medications to manage high cholesterol.
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Sleep apnea. Get adequate sleep and have a sleep study if there is concern for sleep apnea.
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HAVE REGULAR CHECKUPS. Discuss your individual stroke risk with your primary healthcare provider.
TREATMENT
More good news is that our options to treat stroke have never been greater than today. The decision for treatment depends on the type of stroke.
For any type of stroke Every Minute Counts: Quick treatment = Less brain damage
Calling 911 is generally the best way to get to the hospital fast. Stroke treatment can begin in the ambulance. At the hospital, neurological exams are performed and diagnostic tests to determine the type of stroke include CT scan and/or MRI of the brain.
Ischemic Stroke (blocked artery) accounts for 87% of strokes and is treated by getting rid of the clot and restoring blood flow. This can be achieved by:
Clot busters. The medication Alteplase, also known as tissue plasminogen activator (TPA), is a medication administered via IV to dissolve the clot. The goal is to give this medication as soon as possible (and hopefully within 4 ½ hours of the onset of the stroke). Hospitals measure ‘door-to-needle’ times with a goal of administration of TPA within 60 minutes or less from the patient’s arrival to the emergency room.
Mechanical thrombectomy. In this procedure, a specialized catheter is threaded into an artery (typically through the groin or wrist) and the clot is physically removed by aspiration (suction) or a special device that can retrieve the clot. The goal is to perform this procedure as soon as possible (and hopefully within 24 hours of the onset of the stroke).
Hemorrhagic Stroke (ruptured artery) is treated by controlling the bleeding. Blood vessels may tear/rupture due to an underlying aneurysm (weakened blood vessel), an abnormal tangle of arteries and veins (arteriovenous malformation or AVM), or weakening of blood vessels from long-term high blood pressure. Bleeding can be controlled by:
Hemostatic therapy. Medications can be given to reverse the effects of any blood-thinning medications and to lower blood pressure.
Surgery. Surgical options include aneurysm repair (stent, coil, clip) or removal of any arteriovenous malformation that may be leading to the bleed.
Other medication. Medications to prevent seizures may also be given.
DO YOU KNOW WHAT TO DO?
Re-visiting our scenario at the beginning: sudden onset of a headache and slurred speech are signs of a possible stroke. You would call 911 immediately and make note of the time the symptoms started to inform the paramedics.
LOCAL RESOURCES
Hamilton has two accredited Primary Stroke Centers, meaning they have demonstrated excellence in the care of stroke patients and can administer thrombolytic treatment. Additionally, in 2024, both received the American Heart Association’s Get With The Guidelines® Stroke Gold Plus quality achievement award.
TriHealth Bethesda Butler Hospital is designated as a Primary Stroke Center by The Joint Commission.
Kettering Hospital Hamilton is accredited by the Accreditation Commission for Health Care as a Primary Stroke Center
Additional Information:
The information for this article came primarily from the American Stroke Association. For additional information, including a Stroke Risk Assessment and an interactive experience related to the warning signs of stroke, check out their website at https://www.stroke.org